Document Detail

Three years' experience with an ileal low pressure bladder substitute.
MedLine Citation:
PMID:  2920259     Owner:  NLM     Status:  MEDLINE    
At the beginning of this century it was realised that peristalsis would cause incontinence if bowel was used for augmentation or substitution of the bladder. Trans-section of the antimesenteric border and cross-folding of the intestinal segments (Goodwin's cup-patch technique) is an efficient means of solving this problem and has been successfully used in the Kock pouch. We anastomosed the ileal low pressure reservoir to the membranous urethra in 22 male patients following radical cystoprostatectomy for bladder cancer. The mean observation time was 16 months (range 3-36). The capacity of the bladder substitute increased with time, the average being 450 ml after 6 months. In the first 4 patients with a short (2-5 cm) intestinal segment between the pouch and the urethra, micturition was prolonged, residual urine varied from 50 to 300 ml and bacteriuria was found. Occasional expulsions of several ml of urine were caused by peristalsis within this short tubular segment. In the following 18 patients, the low pressure reservoir was anastomosed directly to the membranous urethra. Micturition was good, with no notable residual urine, no bacteriuria and no paroxysmal urinary incontinence. However, a safety pad is used by half of the patients because once or twice a week, mainly at night, a few ml of urine may be lost. No significant changes in serum electrolytes, bicarbonate or creatinine were noted. With the three different antireflux techniques used, no obstructive or inflammatory changes in the upper urinary tracts were found, although no long-term antibiotic prophylaxis was given.
U E Studer; D Ackermann; G A Casanova; E J Zingg
Related Documents :
1499629 - The wardill test: does it predict future voiding flow?
9705549 - The urethra (upp, mupp, instability, lpp).
961889 - Time course of ureteral changes with obstruction.
8240749 - Urodynamic evaluation in pediatric neurogenic bladder.
839599 - Techniques and results of urodynamic evaluation of children.
4009829 - Improved continuous flow transurethral prostatectomy.
18273539 - Prospective randomized trial comparing a nitinol self-expanding coronary stent with low...
17885259 - Pioglitazone exerts protective effects against stroke in stroke-prone spontaneously hyp...
8573799 - Development of an electrohydraulic total artificial heart at the national cardiovascula...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  British journal of urology     Volume:  63     ISSN:  0007-1331     ISO Abbreviation:  Br J Urol     Publication Date:  1989 Jan 
Date Detail:
Created Date:  1989-04-10     Completed Date:  1989-04-10     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  15740090R     Medline TA:  Br J Urol     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  43-52     Citation Subset:  IM    
Division of Urology, Inselspital, University of Berne, Switzerland.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Aged, 80 and over
Anastomosis, Surgical
Ileum / surgery*
Middle Aged
Urethra / surgery*
Urinary Bladder / surgery*
Urinary Bladder Neoplasms / surgery
Urinary Diversion*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Bladder replacement by ileocaeco-urethrostomy or ileo-urethrostomy with a reservoir after cystoprost...
Next Document:  The enigma of interstitial cystitis--an autoimmune disease?